PURE HOME WATER’S SOCIAL

BUSINESS: DISSEMINATING
CERAMIC WATER FILTERS & BUILDING
A CERAMIC FILTER FACTORY
IN NORTHERN GHANA

Susan Murcott Brandeis University, Heller School, Lunch Talk,

Sr. Lecturer, MIT Friday, March 12, 2010
Founder, Pure Home
Global Situation
 1.8 million children die each year from
diarrheal diseases, which kills more
children than AIDS, malaria and measles
combined.
 In recent years, awareness and funding
directed towards reducing disease and
death from diarrhea have been
insufficient to address the enormous
disease burden… it has been an
“invisible” problem, mostly affecting
poor women and children.
Leading Infectious Killers -
2002
4.0 3.9
Over age 5
3.5 Under age 5

3.0
2.8
Deaths in millions

2.5

2.0 1.8
1.6
1.5
1.3

1.0
0.6

0.5

0.0
Lower HIV/AIDS Diarrhoeal Tuberculosis Malaria Measles
Respiratory Diseases
Infections
Source: WHO 2004
Main Diseases Contributing to the
Environmental Burden of Disease, Among
Children 0-14 years

Among children 0 – 14 years, the proportion

of deaths attributed to the environment is W H O , Pre ve n tin g D ise a se …,
Children Under 5 Years-
Mortality
Outline of Questions
Addressed
 What has Pure Home Water (PHW) done
to save lives from water-related
diseases?
 What will PHW do to save lives?
 How many lives can PHW save?
 On what basis, scientific, past experience,
etc. does PHW believe these many lives
can be saved?
 How many dollars does PHW need to
accomplish this objective?

What has Pure Home Water
done…

… to sa ve live s?
 Pure Home Water- Ghana
Pure Home Water (PHW) is a
social enterprise founded in
2005 by MIT Senior Lecturer,
Susan Murcott, with Ghanaian
partners, to provide safe
drinking water via ceramic pot
filters.

PHW has 2 goals:

1. Reach people most in need of
safe drinking water in
Northern Ghana, the poorest
part of Ghana
2. Become financially and
locally self-sustaining
Village women training in
 Pure Home Water (2005-2009)
has:
Sold over 12,000 filters and Kosim is a
reached over 100,000 people word in the
with ceramic pot (Kosim) local
filters, through direct sales
and emergency distributions Ghanaian
(flood, guinea worm outbreak) Dagbani
Developed educational materials language,
and a trainer’s manual on meaning
filter use “pure
Provided water/sanitation/hygiene water”
trainings to > 1,000
communities, groups and
individual users.
Established an office, training
center, water quality
laboratory and guest house.
Provided employment to > 20
Ghanaians.
Pure Home Water (2005-2009)
has:

Pu
Pure Home Water (2005-2009)
has:
 Procured, distributed,
trained users, and
monitored > 7,000
households during a
flood emergency in
Northern Ghana that
affected 200,000
people.
 Conducted follow-up
monitoring of over
2,000 users, many in
remote rural areas, in-
home service and re-
education of users on Filter distribution
filter operation and during floods
maintenance
 Hosted MIT teams to
provide special
assistance to local
Monitoring results from flood
filters
2009 Guinea Worm
Distribution
 2000 Filters: Training, Dissemination &
Monitoring

Woman from Yesapi, Central Gonja, with bandage covering guinea worm-
infected foot
W h a t is Pu re H o m e W a te r…

…planning to do to save lives?

Pure Home Water
Current and Future Plans (2010 –
2015)
 Reach 1 million people in
Northern Ghana with
ceramic pot (Kosim)
filters
 Complete Phase 2
construction of a
ceramic filter factory in
Taha Ghana (Phase I
completion done by Jan.
2010.)
 Improve filter design and
quality control of
process variables.
 Complete all construction
in 2011 (Phase 3:
residential/guest
building)
 Become financially self-
How many lives can we save?

Credit: Alexandr Nishichenko

 Childhood Mortality Stats
U n d e r 5 M o rta lity R a te / 1 0 0 0 Live
 Ghana’s average B irth s
childhood mortality
is 112 deaths / 1000
live births
 There are significant
North/South
differences The
majority of Northern
Region and the WHO Ghana Country Fact Sheet
Upper West both
75-100
have >155 deaths / 101-127
1000 live births. 128-154
155-180
>181
Africa’s rate is 167
(http://www.afro.who.int/home/countries/fact

deaths / 1000 live

_sheets/ghana.pdf)
 Background
W a te r: 5 0 % o f p e o p le in
N o rth e rn G h a n a la ck
a cce ss to a n im p ro ve d
w a te r su p p ly
S a n ita tio n : G h a n a h a s th e
4 th worst record in the
world for sanitation
coverage, meaning most
people in Northern Ghana Contaminated water supply
practice open defecation.
This deplorable
water/sanitation situation
leads to a very high rate
of diarrheal diseases and
death, especially among
children under 5 years.
Ghana is also one of the 5
remaining guinea worm
Midwife training at Pure Home Water
endemic countries
Improved and Unimproved
Sources
5 0 % ( 0 . 9 m illio n o u t o f 1 . 8 m illio n p e o p le ) in N o rth e rn R e g io n u se a n
u n im p ro ve d so u rce
 Improved Sources
 Boreholes
 Household
connection
 Public standpipe
 Rainwater
harvesting
 Protected springs
and dug wells


 Unimproved Sources
 All surface water
sources
 Unprotected
springs and dug
wells
 Tanker trucks
Northern Ghana Health Stats
 Upper West and Upper East, two of Pure Home
Water’s target regions, have the highest rates of
diarrhea prevalence in Ghana, 27% and 21%
respectively,
.
plus guinea worm in the North.
Ghana and Guinea Worm
Ghana is one of five remaining guinea
worm
 endemic countries (2nd worst, after

Sudan

Photo: Braimah Apambire, World Vision

Sanitation Coverage
 Ghana has the
4th lowest
rate of
sanitation
coverage in
the world
Sanitation Coverage
 In Pure Home
Water’s region,
sanitation
coverage is
“none” or
“public” for the
majority of
people.... This is
considered
“inadequate” by
U.N. definitions.
Sanitation Coverage
 Latrine in the
process of being
built
 Brick from Pure
Home ceramic
factory could go
toward
appropriate
latrine
construction

Scientific Evidence


 What scientific evidence do

we have that the Kosim
ceramic pot filter reduces
risk of diarrhea?

Study of Impact of Ceramic Pot Filter in
Northern Ghana (2006-2007) on Diarrhea

Under supervision of MIT advisor, Susan Murcott

and with guidance from Harvard School of Public
Health Professor Julie Bering, M IT M a ste r o f
E n g in e e rin g stu d e n ts R . Pe le tz ( 2 0 0 6 ) a n d S . Jo h n so n
( 2007 ) conducted a baseline and health impact
su rve y in Ta m a le a n d S a ve lu g u D istricts, N o rth e rn
R e g io n , G h a n a . T h e ir g o a lw a s to fin d o u t th e ro le o f
th e ce ra m ic p o t filte r, b ra n d e d lo ca lly a s th e “ Kosim”
filter in reducing diarrheal diseases. They surveyed
traditional and modern households with and without the
ceramic pot filter.
 Traditional and Modern
Households Surveyed
Modern Households
(Peletz, 2006)
Peletz’s sample population was 50
modern urban families in Tamale
and Savelugu Districts with and
without the ceramic filter.

Traditional
Households
(Johnson, 2007)
Johnson’s sample population was 41
traditional rural families in
Tamale and Savelugu Districts
with and without the ceramic
filter.
Peletz (2006) – Relative Risk
Analysis
 Peletz found that modern households
with ceramic filters have 12% of
the risk (88% less risk) of having
diarrheal illness compared to
households without filters. Results
were statistically significant.
Diarrhea No Diarrhea


Filters 1 10
No Filters 18 21
Odds Ratio= (1x21) = 0.12 Statistically
significant (p<.001)
(18x10)
Johnson (2007)– Relative Risk
Analysis
 Johnson found that traditional rural
households with ceramic filters
have31% of the risk (69% less
risk) of having diarrheal illness
compared to households without
filters. Results were statistically
Diarrhea No Diarrhea
significant.
 Filter 4 219
No Filter 12 203

Odds Ratio= (4x203) = 31% Statistically significant

(p<0.035)
(12x219)
Prior Studies on Health Impact

 “Quantitative Assessment of Health

Benefits of HWTS”
(Nath,K.J., Bloomfield,S., and Jones,M. 2005)

“The evidence shows that provision of

safe water alone at the household level

can reduce diarrhoeal and other enteric

diseases by 6 to 50%, even in the

absence of improved sanitation or other

hygiene measures.”

 (based on literature review of 16 selected

epidemiological studies of a range of HWTS options)
Differences in Study Results
 Why did Peletzand Johnson have high
numbers (88% less risk, 69% less risk)
compared to Nath’s review of similar
studies?
 The Peletz/Johnson sample sizes were small,
limited by time and funding constraints,
which may led to a wider margin of error.
 Also confounding factors, besides the filters,
might have contributed to such a high %
reduction among those families using the
filters.
 Hence, we should consider the Peletz/Johnson
conclusions as preliminary.

 So… how many lives do we
estimate that Pure Home
Water will save by building a
local ceramic filter factory to
reach 1 million people in
Northern Ghana?
Conclusion:
 We conservatively estimate that we
should be able to reduce diarrheal
disease - the 2nd leading cause of
death in children under 5 years in
Ghana – by 25-50% among those
households consistently and correctly
using the Kosim ceramic pot filter
 1 million people will have an improved
quality of life due to reduction of
diarrhea, guinea worm and other
water-related diseases and deaths
 In addition to saving lives, why has
PHW decided after 5 years to
•proceed with local manufacturing?
•
•
•

Cost – to bring the price

of the filter into reach of
$1/day people
Supply Bad Roads, Very Hot,
Dusty Weather

Chain
PHW Truck

District Gov’t
Warehouses

Villagers
Pure Home Water
Office/Stockroom Ceramica Tamakloe
Quality Control
 Breakage

Technical modifications to design and/or materials to increase durability

 Design Modifications
Flower Pot, Bowl or Paraboloid-
Shaped Ceramic Filter

Standard flat-bottom Round bottom shape Paraboloid shape

shaped of flower-pot Myanmar in Nigeria and
design Dominican
Republic
 Budget Summary:
Ceramic Filter Factory Construction
Phase 1 & 2
ITEM US$

Total Estimated Budget to Construct Filter Factory$111,000

Amount spent to date on land ($10K) & $43,000

construction ($33K)

Amount needed to complete Phase 2 $68,000

 More information: Pure Home Water
 http://www.purehomeh2o.org


Thank You
 References

• Rogers, P. Water and Child Health: An Environmental Perspective

Presentation to the World Health Organization’s Task Force on the
Children’s Environment and Health Action Plan for Europe (CEHAPE),
Limassol, Cyprus, October 16-17, 2006.
• WHO, 2002 and 2004 – http://www.who.int
• WHO, 2006. Preventing Disease through Healthy Environments.
• http://www.who.int/quantifying_ehimpacts/publications/preventingdisease/en/
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